Development of an Access System for Diphtheria-Tetanus Vaccination in Individuals Aged 20 and Over: Application of Motivational Interviewing and Community Health Volunteer Participation in Selaphum Subdistrict Municipality, Selaphum District, Roi Et Prov

Abstract

     This Participatory Action Research (PAR) aimed to develop a system for increasing access to diphtheria-tetanus (DT) vaccination among adults aged 20 years and older by applying Motivational Interviewing (MI) and strengthening the participation of Village Health Volunteers (VHVs). The research utilized a Participatory Action Research (PAR) design with two cycles. The sample included 29 VHVs and 100 community members in Selaphum Municipality, Roi Et Province, Thailand. The research instruments comprised a knowledge test on DT vaccines, an MI skills assessment form, and a participation scale for VHVs. Data were analyzed using descriptive statistics (mean, standard deviation) and inferential statistics (paired t-test) to compare pre- and post-intervention scores.

     In the first cycle, post-training results showed a significant increase in VHVs' knowledge scores (from a mean of 10.72 to 16.62) and MI skills scores (from 2.05 to 2.63) (p<0.001). In the second cycle, community members who received MI-based counseling demonstrated significantly improved knowledge and attitudes toward vaccination. The vaccination uptake rate reached 72%. Moreover, the mean participation score of VHVs increased from 2.01 to 2.54 (p<0.001).